Organizational Development: Driving Forces and Barriers Encountered when Implementing Smoking Cessation Programs

Abstract

Background: Globally, use of tobacco has been identified as one of the greatest risk factors for mortality and the leading cause of preventable death. The purpose of this paper was to apply the lens of a business change model to the healthcare sector to better understand forces driving the implementation of smoking cessation programs and to identify ways to overcome resistance to changes in smoking behaviour and protocols.Methods: This paper used a case study approach. Through the interpretation of real-life situations and problems faced by researchers at the University of Ottawa Heart Institute (UOHI), the relationship between society’s view towards smoking (drivers of change) and the unique issues encountered when implementing smoking cessation programs (barriers to behavioural change) were explored. Results: Legislation and health centre regulations have been drivers of change; however, the government-authorized sale of tobacco is still a significant barrier to overcome. At the organizational level, goals and objectives are not clearly defined which resulted in confusion regarding participants’ roles, duties and performance standards. At the practitioner level, physicians who demonstrated a lack of confidence in their ability to counsel patients about quitting offer fewer clinical cessation activities. At the patient level, many smokers associate smoking with activities they enjoyed and believed smoking improved their ability to cope with stress, anxiety and/or boredom. Conclusions: Stronger legislation and making smoking cessation part of the healthcare institution’s mission to provide quality care and outreach, can clarify the importance of developing objectives to attain these goals among key stakeholders.